Job Information
State of Colorado Medicaid Fraud Investigator (Special Agent III) in Denver, Colorado
Medicaid Fraud Investigator (Special Agent III)
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Medicaid Fraud Investigator (Special Agent III)
Salary
$96,396.00 - $116,400.00 Annually
Location
Denver, CO
Job Type
Full Time
Job Number
LAA-00027-8/2024
Department
Department of Law
Opening Date
08/22/2024
Closing Date
9/16/2024 11:59 PM Mountain
FLSA
Determined by Position
Type of Announcement
This position is open only to Colorado state residents.
Primary Physical Work Address
1300 Broadway, Denver, CO 80203
Department Contact Information
Daisy Zepeda: daisy.zepeda@coag.gov
How To Apply
Please submit an online application for this position at https://www.governmentjobs.com/careers/colorado. Reach out to the Department Contact to apply using a paper application, including any supplemental questions. Failure to submit a complete and timely application may result in the rejection of your application. Applicants are responsible for ensuring that application materials are received by the appropriate Human Resources office before the closing date and time listed.
Description
Benefits
Questions
Department Information
This position is open only to Colorado state residents.
This posting is being extended and is now scheduled to close on 11:59 pm on September 16th. If you have already submitted an application, you do not need to reapply.
The Consumer Protection Section is seeking an experienced investigator to join the Colorado Medicaid Fraud Control Unit (“COMFCU”). The COMFCU is crucial to preventing and holding providers accountable for Medicaid fraud and patient abuse across the state of Colorado. This position is ideal for someone who not only takes pride in the skills and abilities that they have developed thus far in their career, but seeks to expand that skillset while working in a fast-paced environment and making a difference for Colorado’s most vulnerable populations.
WHO WE ARE
The Office of the Attorney General/Department of Law is the "People's Lawyer". The Attorney General, Phil Weiser, was elected by the people of Colorado and is the State's chief lawyer and law enforcement official. Our vision for the Department of Law is: "Together, we serve Colorado and its people, advancing the rule of law, protecting our democracy and promoting justice for all." Our core values and commitment to diversity, equity, and inclusion, drive our actions and demonstrate our focus on being principled public servants who are innovative and better together.
Visit our website to learn more:https://coag.gov/.
Description of Job
WHAT YOU WILL DO
The COMFCU maintains a strong commitment to ensuring that Coloradans have access to the highest quality of care from dedicated providers while continuing to take an aggressive approach to preventing and prosecuting Medicaid fraud and patient abuse across the state.
The dual missions of the COMFCU are:
To protect the state and federal funds dedicated to providing health care and medical services to Colorado Medicaid beneficiaries.
To hold individuals accountable for the abuse, neglect, or financial exploitation of clients in board and care facilities as well as those in facilities that accept Medicaid dollars.
This unit receives multiple referrals and evaluates them to determine if they warrant further investigation and criminal prosecution in state court. Often, the unit acts as the lead investigative agency gathering information from partnering law enforcement and regulatory agencies, not limited to numerous local, state and federal agencies within the State of Colorado.
The Investigator position is a critical team member of the COMFCU that will work both independently and as part of a multidisciplinary team to c onduct civil and criminal investigations, litigation, and prosecution of fraudulent activity by Medicaid providers (such as hospitals, doctors, pharmacies, nursing homes, etc.) and of patient abuse (such as physical assault, sexual assault, homicide and embezzlement of patient trust funds). This position may also be assigned to civil investigations in support of the Colorado False Claims Act. Additionally, the incumbent will provide technical training, advice and assistance to other law enforcement agencies in various jurisdictions across Colorado in the investigation of such matters.
This recruitment may also be used to fill other Special Agent positions in the Consumer Protection section.
Minimum Qualifications, Substitutions, Conditions of Employment & Appeal Rights
WHAT WE ARE LOOKING FOR
Minimum Qualifications: Please document all relevant experience in detail on your application. Experience will not be inferred or assumed. Any part-time experience listed will be prorated.
Six years of professional investigative experience as a sworn detective or criminal investigator at the felony level for a government law enforcement agency.
OR
A combination of directly related education (such as Criminal Justice, Psychology, or Sociology) and professional investigative experience as a sworn detective or criminal investigator at the felony level for a government law enforcement agency equal to six (6) years.
Required Competencies: The following knowledge, skills, and abilities are required for this position and will be considered during the selection process, including examination and/ or interview:
Demonstrated organizational skills, including the ability to multi-task, prioritize tasks, and meet deadlines;
Demonstrated work experience managing or leading large-scale or complex investigations;
Strong oral and written communication skills, including the ability to communicate concisely and effectively;
Customer service and interpersonal skills, including the ability to work on a team;
Strong critical thinking and analytical skills.
Preferred Qualifications: In addition to the minimum qualifications, if you possess any of the following specifically include the details on your application, as this information will be used to assess your qualifications and may be used to determine a top group of applicants.
Experience investigating and researching matters involving violations of State and Federal regulations;
Work experience with Medicaid or Medicare regulations and statutes;
Experience investigating document intensive white collar fraud cases from intake to completion;
Experience working with medical records and bank records during the course of an investigation;
Work experience with database programs, such as Excel or Access, used to analyze data and track evidence;
Proficiency in Spanish, Chinese, German, Vietnamese, or another commonly spoken language in Colorado;
Training as a forensic interviewer;
Experience in planning tactical operations;
Experience working with multidisciplinary investigation and prosecution teams, including with state or federal agency partners;
Experience conducting public outreach;
Certified Fraud Examiner;
Experience/training as a FTO or as a LE instructor;
Participation with health care fraud or elder abuse task forces or committees;
Experience investigating cases involving vulnerable populations, including working cases involving victims/witnesses with developmental or intellectual disabilities.
Experience working in a fast-paced environment that involves managing an active caseload.
Conditions of Employment:
Candidates must be Colorado P.O.S.T. certified at the time of application. In accordance with C.R.S. §24-31-303 (5)(a) and (b), applicants must be Colorado P.O.S.T. certified, including the requirement of completing a physical and psychological evaluation (if it has been more than three years since a physical and psychological evaluation has been conducted). Following a conditional job offer, but prior to appointment, a candidate not meeting the requirement of C.R.S. §24-31-303(5)(b) will be subject to a physical and psychological evaluation to determine fitness to serve as a peace officer. Must be proficient with a handgun. Must be available, sometimes on short notice, to travel within and outside the State of Colorado. Must be available to work nights and/or weekends when necessary to conduct fast-paced investigations, execute search warrants, or prepare for trial.
Applicants must pass a thorough criminal and personal background check, including a review of the personnel file from prior employment.
Position may be required to work outside of regular business hours, including possible early mornings, evenings, weekend, and overnight assignments. This is not an on-call position. Position must have a valid CO driver's license.
This position may be eligible for flexible work arrangements, including a hybrid work schedule after an initial training period.
HOW TO APPLY
Required Application Materials: Applicants may redact information that identifies their age, date of birth, or dates of attendance at or graduation from an educational institution.
A completed State of Colorado Application: Applicants are responsible for ensuring that the application provided is fully completed and clearly describes their education, training and experience as it relates to this position. Applications left blank or marked “See Resume” will not be considered.
Writing Sample: As part of your application, please attach a writing sample. While an affidavit is strongly preferred, but a summary of investigation prepared in a complex case, or a substantial criminal investigative report will also be accepted. If you do not attach this writing sample, your application will be removed from consideration.
Veteran’s Preference: In order to be considered for veteran’s preference you must attach a copy of your DD214 forms as well as any documentation required to prove disability or marital status.
FOR CURRENT OR FORMER EMPLOYEES OF THE STATE OF COLORADO:
All current and former State employees must ensure that your entire work history within the State Classified System, including at Institutions of Higher Education, is indicated in your application so that your time-in-series can be calculated accurately.
Your application will be reviewed by a qualified Human Resources Specialist to determine if you meet the minimum qualifications for this position. If your application does not demonstrate that you meet the minimum requirements, you will be notified that you will not proceed in the selection process for this position. If your application is rejected and you have questions, you may contact Daisy Zepeda at 720-508-6510 ordaisy.zepeda@coag.gov.
Assessment Information:
Colorado Revised Statutes require that all state employees be hired and promoted through comparative analysis of merit and fitness. Upon meeting the minimum qualifications, the next phase of the process is typically a structured application/resume review by a panel of subject matter experts against the job duties and/or preferred qualifications in this job announcement to determine technical competence, depth and breadth of experience and potential job fit.
Technical Competence – Technical experience as it relates to the duties outlined in this job announcement.
Depth and Breadth of Experience – Experience that covers multiple areas outlined in this job announcement and demonstrates the level of responsibility assigned.
Job Fit – Experience will be evaluated to determine how well experience aligns with and meets the business needs of this position. Current experience is preferred.
It is imperative that the “Work Experience” section of your application is complete and specifically addresses your qualifications, experience, work product, and accomplishments as they relate to the Description of the Job, Minimum Qualifications, and Preferred Qualifications as listed above. Failure to include adequate information or follow instructions by the closing date may result in your application not being accepted and/or may affect your inclusion in the final pool of eligible applicants as the materials may be used to identify a top group for additional assessment or establish an eligible list for referral to the hiring manager for final consideration.
Appeal Rights: If you receive notice that you have been eliminated from consideration for this position, you may file an appeal with the State Personnel Board or request a review by the State Personnel Director.
An appeal or review must be submitted on the official appeal form, signed by you or your representative. This form must be delivered to the State Personnel Board by email, US Mail, faxed or hand delivered within ten (10) calendar days from your receipt of notice or acknowledgement of the department’s action.
For more information about the appeals process, the official appeal form, and how to deliver it to the State Personnel Board go tospb.colorado.govor refer to 4 Colorado Code of Regulations (CCR) 801-1, State Personnel Board Rules and Personnel Director's Administrative Procedures, Chapter 8,Resolution of Appeals and Disputes, atspb.colorado.govunder Rules.
Supplemental Information
WHY WORK FOR US
We Embrace Flexibility
We aim to produce outstanding work product for all of our customers
We Are Committed to Diversity, Equity and Inclusion
At the DOL, our commitment to DEI is thriving. We know that we are better together when our differences are valued and everyone is inspired and empowered to contribute. As such, we strive to provide a safe environment where individuals feel valued and respected for who they are; demonstrate a behavior and mindset where differences are welcomed, and individuals are treated equally and empowered to do their best work; and promote growth and innovation through a diverse workforce. We empower an active Diversity Equity & Inclusion Impact Team that creates approaches to ensure safe spaces and a culture supportive of people being their authentic selves, hosts events and programs on DEI areas important to our employees, enables development and sustainability of resource groups that give a voice to historically marginalized populations, focuses on retaining our incredible talent, and more! If your professional goals include promoting growth and innovation with colleagues who recognize that we are better together when our differences are valued and respected, then DOL is your place to be!
We Have Strong Core Values
Our core values drive our actions. At the Department of Law, we are: 1) principled, maintaining the highest ethical standards, rigorous legal analysis, and careful evaluation of facts; 2) public servants, who are always ensuring our work is not about us, but instead is about the people of Colorado; 3) innovative, by seeking to identify the best approach, make deliberate decisions, and look to improve; and 4) "better together," by working to support each other and collaborate.
We are Committed to Developing our Employees
We are deeply invested in our talent and regularly provide meaningful opportunities for personal and professional growth through training and coaching. Further, our professional development and performance goal setting process is collaborative and ongoing, and aimed at helping our employees grow and succeed.
We Offer Excellent Benefits
In addition to the comprehensiveState of Colorado benefits package (https://stateofcoloradobenefits.com/) including competitive medical and dental health plans, employer-paid life insurance, paid holidays, retirement plans withColorado PERA (https://www.copera.org/members/retirement-benefits) , and vacation and sick leave earned each month, there are many other unique benefits that we offer, including:
Medical (https://www.colorado.gov/pacific/dhr/medical) anddental (https://www.colorado.gov/pacific/dhr/dental) health plans
Employer-paid life insurance
Paid vacation and sick leave earned each month
10 paid holidays per year
Public Service Loan Forgiveness (https://studentaid.gov/manage-loans/forgiveness-cancellation/public-service) – A borrower may qualify for forgiveness by making 120 on-time payments while employed full-time in public service, if they have certain kinds of federal loans in a qualifying repayment plan
Free access to an on-site fitness center
Strong, flexibleretirement benefits (https://www.copera.org/sites/default/files/documents/5-112a.pdf) including 401K and 457 plans
Distinctive career advancement opportunities throughout the State personnel system
Excellent work-life programs, such as flexible work schedules, professional development opportunities, and an employee discount program
We value quality of life for our employees, and do not require on-call or shift work for this position.
To learn more about our benefits visit:https://www.colorado.gov/dhr/benefits.
The State of Colorado believes that equity, diversity, and inclusion drive our success, and we encourage candidates from all identities, backgrounds, and abilities to apply. The State of Colorado is an equal opportunity employer committed to building inclusive, innovative work environments with employees who reflect our communities and enthusiastically serve them. Therefore, in all aspects of the employment process, we provide employment opportunities to all qualified applicants without regard to race, color, religion, sex, disability, age, sexual orientation, gender identity or expression, pregnancy, medical condition related to pregnancy, creed, ancestry, national origin, marital status, genetic information, or military status (with preference given to military veterans), or any other protected status in accordance with applicable law.
The Department of Law is committed to the full inclusion of all qualified individuals. As part of this commitment, our agency will assist individuals who have a disability with any reasonable accommodation requests related to employment, including completing the application process, interviewing, completing any pre-employment testing, participating in the employee selection process, and/or to perform essential job functions where the requested accommodation does not impose an undue hardship. If you have a disability and require reasonable accommodation to ensure you have a positive experience applying or interviewing for this position, please direct your inquiries to our ADAAA Coordinator, Julie Christopher, at Julie.Christopher@coag.gov or call 720-508-6511 .
If you have any questions regarding this position, please contact HR Specialist Daisy Zepeda atdaisy.zepeda@coag.gov
The State of Colorado offers permanent employees a variety of benefits including medical, dental, life and disability insurance, as well as a comprehensive leave program. Please click the following link for detailed information: www.colorado.gov/pacific/dhr/benefits
Please note that each agency's contact information is different; therefore, we encourage all applicants to view the full, official job announcement which includes contact information and class title. Select the job you wish to view, then click on the "Print" icon.
01
A condition of employment for this position is that candidates must be Colorado P.O.S.T. certified at the time of application. Please include your PID.
02
A writing sample is required along with the completed employment application. This document can be submitted using the "Attach" feature. Please confirm that you have submitted the required writing sample.
Yes
No
03
Please describe your experience as a fulltime detective or criminal investigator at the felony level, including the types of crimes you investigated. Please provide the place where you gained the experience and dates of employment.
04
Please describe your experience as a full-time detective or investigator, including any experience you may have in the following areas: Investigations of white-collar financial crimes, elder abuse crimes, and crimes involving vulnerable populations or abuse and neglect. Please include your experience in reviewing, organizing, and tracking document-intensive financial or health care records during such investigations.
05
Please describe your experience in providing training to law enforcement personnel. Please include a list of subject areas you have taught in your response.
Required Question
Agency
State of Colorado
Address
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Website
https://careers.colorado.gov/
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